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Infection in Oral & Maxillofacial Region

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Presentation on theme: "Infection in Oral & Maxillofacial Region"— Presentation transcript:

1 Infection in Oral & Maxillofacial Region
Pandect Yu Chuang-Qi

2 Infection--- in oral & maxillofacial region
Pandect Infection--- in oral & maxillofacial region Infection Conception Trait Anatomy Arising Route Mutation Influence factors Diagnosis Principles Treatment Principles

3 Infection---conception
Infectious agent(bacteria) Host Inflammatory reaction protective and defensive Beneficial Elimination the infectious pathogen Repair tissue injury Harmful Hypersensitivity Autoimmune disease

4 Trait of anatomy Oral and nasal cavity Tooth Space
Blood and Lymphoid system Bacteria

5 Trait of anatomy Bacteria---Exist Oral and nasal cavity
Maxillary sinus(上颌窦) Temperature + Moisture (Beneficial) Reproduction + Developing

6 Trait of anatomy Tooth Caries Alveolar bone Pulpitis Soft tissue
Apical infection Alveolar bone Soft tissue Fascial space

7 Trait of anatomy Fascial space(间隙)---loose connective tissue
Among skin, maxillary and muscle Purulent--- spreading way Do not exist in healthy state Become filling during infection

8 Cavernous sinus thrombosis
Trait of anatomy Blood and lymphoid system Beneficial Abundance Harmful Encephalic infection Dangerous triangle Lacking valves Cavernous sinus Cavernous sinus thrombosis

9 Trait of pathogenic bacterium
Flora(菌丛) Varied Numerous Streptococcus hemolyticus (溶血性链球菌) Staphylococcus aureus (金黄色葡萄球菌) Escherichia coli (大肠杆菌) Anaerobe (厌氧菌) Sterile Simple Complex

10 Route of infection Odontogenic infection Adenogenous(腺源性) infection
Traumatic infection Hematogenous(血源性) infection Iatrogenic(医源性) infection

11 Odontogenic infection
Periapical infection Pericoronitis(冠周炎)

12 Periapical infection Acute-chronic Periapical infection Fistular(瘘)
Cellulitis (蜂窝织炎) Intraoral soft tissue abscess (脓肿) Osteomyelitis (骨髓炎) Septicemia(败血症) Deep fascial space infection Ascending facial-cerebral infection

13 Pathways of Periapical infection

14 Pericoronitis (冠周炎) Lower third molar

15 Infection---Arising Host--- defense system
Microbe---virulence quantity Local circumstance Balance Imbalance Scale

16 Mutation Influence factors Changing directions

17 Influence factors Host--- defense system Microbe---virulence quantity
Treatment strategy

18 Changing directions Localization and recovery Acute chronic Diffusion
Blood system---Septicemia lymphoid system---Lymphadenopathy From submandible space infection to chest region

19 How to diagnose? Local Signs and Symptoms
Systemical Signs and Symptoms

20 Local Signs and Symptoms
Locally Pain Swelling Surface erythema Pus formation Limitation of motion

21 Systemical Signs and Symptoms
Fever Lymphadenopathy Malaise Toxic appearance Elevated white blood cell count

22 How to treat? Acute stage Chronic stage

23 Acute stage Host Antibiotic therapy Surgical drainage and incision

24 Host Defense Mechanisms Critical Principles
Migration of white blood cell Production of antibodies Critical Principles Most important factor --- final outcome The infections--- cured by the host, not by antibiotics

25 Principles for choosing appropriate antibiotic
Antibiotic era causative organism(致病菌) sensitivity specific, narrow-spectrum antibiotic least toxic antibiotic drug history(success, allergic and toxic)

26 Principles of antibiotic administration
Proper dose Proper time interval Proper route of administration(oral, parenteral) Combination antibiotic therapy

27 Surgical drainage and incision
How to judge the pus formation? Purposes of surgical drainage and incision Principles of surgical drainage and incision

28 How to judge the pus formation?
Characteristic Duration--- >5 days Palpation---Fluctuant Appearance---Reddened Needle aspiration B-ultrasound CT Three stages Inoculation Cellulitis Abscess

29 Fluctuant examination

30 Purposes of surgical drainage & incision
Rid the body of toxic purulent material Decompress the tissues Allowing better perfusion of blood containing antibiotics and defensive elements Increased oxygenation of the infected area

31 Infection in masseteric space

32 Infection in multi-space
Ludwig’s angina

33 Principles of surgical drainage & incision
Place the incision in an esthetically acceptable Place the incision in a dependent position to encourage drainage by gravity Dissect bluntly through deeper tissues and explore all portions of the abscess Place a drain and stabilize it with sutures

34 Principles of surgical drainage & incision

35 Chronic stage Surgical removal of the focus(病灶)
Lesion tooth---Impacted tooth Osteomyelitis

36 Infection in oral & maxillo-facial region
Conclusion Infection in oral & maxillo-facial region The trait of Infection Odontogenic infection mutation of infectious Diagnosis of the infection Diagnosis of the abscess formation The principles of the treatment

37 Thank you


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